[jennyyang]

Sometimes, the "science" is wrong. Everything from low-fat diets, to high sodium diets, to DDT, to MSG. Many of the things that we have literally been indoctrinated with have been fully wrong.

Most recently, when the government, most especially the Surgeon General and even Fauci, told people that masks don't work. That infuriated me and they instantly lost credibility with me. And it caused a split in Americans where too many believed that masks didn't work, even after they changed their tune. It was absolutely unnecessary to lie and it killed people.

So read the science. Listen to the science. But read up further, and make educated decisions. Don't just listen to "experts" blindly.

[MaxBarraclough]

> But read up further, and make educated decisions. Don't just listen to "experts" blindly.

I don't see that being very practical. The average person simply isn't qualified to read scientific literature and draw their own conclusions. I doubt I'd be able to make much sense of a research paper on virology or epidemiology, despite that I consider myself scientifically literate in the general sense.

The answer is to have credible communicators of science. The best way to do that is with credible institutions. If the assumption is that this is impossible, the game is already lost.

> the Surgeon General and even Fauci, told people that masks don't work. That infuriated me and they instantly lost credibility with me. And it caused a split in Americans where too many believed that masks didn't work, even after they changed their tune. It was absolutely unnecessary to lie and it killed people.

Broadly agree, although I think anti-mask sentiments are due to mindless partisanship rather than listening to Fauci's early lie.

[falcrist]

> The average person simply isn't qualified to read scientific literature and draw their own conclusions.

Reading the scientific literature is still "trusting the science".

Are we replicating experiments to see for ourselves if the data is correct? Are we re-working the error calculations to make sure the statistical evaluation is correct? Are we studying the topic so we're informed enough to identify poor work as well as the peer reviewers?

I believe the answer to these questions is "no".

[dbtc]

A few centuries back the average person couldn't read at all, so I think there's hope that it can be taught, not just explained.

On the other hand, the separate disciplines are more and more specialized and complex, so then I agree 100% that communication (translation) is key.

Lastly, "mindless partisanship" may be the cause, but is also an effect of other longer/subtler trends in media-tech, culture, education, etc.

[quesera]

> ... even Fauci, told people that masks don't work.

So, this troubles me.

One thing about science, of course, is that you need to be certain of your measuring equipment, and of your observations.

I cannot find any evidence that Fauci ever said that "masks don't work".

I have found:

* Late Feb: "at this moment, there is no need to change anything that you’re doing on a day-by-day basis"

* March 8th: "There's no reason to be walking around with a mask"

* March 8th: "When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face"

* March: "Right now in the United States people should not be walking around with masks … You should think of healthcare providers who are needing them and the people who are ill."

I see:

* ~"No need to panic at this time" (Feb)

* ~"Masks do not confer perfect protection, make sure to use them correctly, social distancing is still required" (Mar)

* ~"Reserve PPE (e.g. N95 masks) for the people who need it most" (Mar)

And shortly after this time, his recommendation changed to strongly recommending masks, when three critical things changed: asymptomatic spread was established, PPE supplies were beginning to stabilize, and testing determined that cloth masks are roughly as effective as surgical masks (not N95 masks).

All of those statements and decisions strike me as reasonable, from a spokesperson for public health in that time frame.

My memory of last spring is that masks were not recommended for the general public, but the clear message was that they do work, otherwise they would not be recommended for health workers.

I do not ever remember any non-political health professionals saying that masks do not work. So it troubles me to see it repeated ad nauseam that Fauci said such a thing.

If I have missed something, please help me out.

[WillPostForFood]

"When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face"

What do you think is being communicated here? It makes you feel better, but there are unintended consequences is worse than they don't work, it is saying they are worse than nothing. Around the same time the Surgeon General more explicitly said they don't work.

“They are NOT effective in preventing general public from catching #Coronavirus, but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!”

Which was an absurd statement at the time - if they are not effective for the public, why would health care providers need them.

https://www.nytimes.com/2020/02/29/health/coronavirus-n95-fa...

[quesera]

This a classic communication error. Media can't handle subtlety of message. It's a mistake Fauci should not make, being a decades-long expert.

But I hear, and I heard at the time, "Masks help, but they are not perfect, and if you use them in the obviously-wrong way, they are useless or harmful".

Which aligns with my understanding of every tool used for any purpose.

The Surgeon General, OTOH, was never a person to be taken seriously. But I don't blame Fauci for that.

[ergocoder]

It wasn't communication error. Fauci admitted he lied for the greater good.

It was really short-sighted. He could have suggested cloth masks.

And Fauci was considered the best COVID thought leader. US is so dead.

[quesera]

> Fauci admitted he lied for the greater good.

Again, this is repeated a lot -- but it does not match my memory, nor can I find evidence of it in my searches.

If you know differently, please share a link.

> He could have suggested cloth masks.

IIRC, the consensus pre-COVID and post-SARS, was that cloth masks are inferior to N95 masks. When the supply of N95 masks was not considered unreliable, there was no need for public health to think about bandanas.

In Feb/Mar, before asymptomatic transmission was proven, it was reasonable to not bother suggesting cloth masks, and simultaneously to preserve the "useful" (N95) masks for the most at-risk.

> US is so dead.

There were so many failures. The system that Fauci was relying upon turned out to not have been funded. Maybe he should have known that, but I'm not sure he had visibility into the problem.

I see Fauci as the firefighter who arrives at the scene, hooks up the hoses, and discovers that the hydrants are dry and the city hadn't bothered to tell anyone.

I'm sure it's more complicated than that. He has definitely made some mistakes, but the system which is supposed to back him up has completely failed him and all the rest of us.

[ergocoder]

"I don't regret anything I said then because in the context of the time in which I said it, it was correct. We were told in our task force meetings that we have a serious problem with the lack of PPEs," he said.

https://www.businessinsider.com/fauci-doesnt-regret-advising...

It makes no sense since cloth masks don't cause PPE shortage.

> IIRC, the consensus pre-COVID and post-SARS, was that cloth masks are inferior to N95 masks. When the supply of N95 masks was not considered unreliable, there was no need for public health to think about bandanas.

It's inferior but still better than nothing.

So, you agree that cloth masks are better than nothing.

> In Feb/Mar, before asymptomatic transmission was proven, it was reasonable to not bother suggesting cloth masks,

The precautionary principle 101.

https://en.m.wikipedia.org/wiki/Precautionary_principle

They should have be cautious first. Like come on, it's beginner's level of crisis management.

They even implied against it (because you would touch your face and etc.)

A tweet from US surgeon general: https://www.jacksonville.com/story/news/healthcare/2020/03/0...

"They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!"

Why would you say masks are NOT effective? With emphasis on NOT.

Fauci never refuted this tweet at the time, so what were we supposed to think?

> I see Fauci as the firefighter who arrives at the scene, hooks up the hoses, and discovers that the hydrants are dry and the city hadn't bothered to tell anyone.

It's more like he showed up and said water didn't help put out fire. Let's not use water.

He also didn't regret it because, well, we were in the water shortage period.

> He has definitely made some mistakes

A mistake that caused many lives.

He made a bad judgement call. Bad at communication with public. No idea how to manage crisis.

Just say "hey, it looks like a flu. We should be cautious and cover our face with something. Please don't buy n95 because doctors need it".

At the time, I covered my face in public and kept saying masks worked, and I felt like an anti-vaxx for going against "science". What a shit show.

[jussij]

Considering this part of his statement I think his message might have even more subtle than that:

but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!

I suspect at the time of the statement, health care works where struggle to get PPE, which would not have been helped by the run on masks by the general public.

In that context I see this a plea for the public to understand a mask in the hand of a medical worker is much more valuable than one in the hand of a member of the public. So lets try and help the medical staff before we try and help ourselves.

[nmfisher]

> The Surgeon General, OTOH, was never a person to be taken seriously. But I don't blame Fauci for that.

Why? I'm not from the USA, so obviously I don't understand the specifics of that position.

[quesera]

The US Surgeon General is a political appointee, with a largely ceremonial role and little policy influence.

Some have been better than others, but they mostly serve as a mouthpiece for the administration's agenda as it relates to health-adjacent matters.

As such, when the President does not take a health matter seriously (historically: AIDS, opioids, obesity, guns, tobacco, mental health, drunk driving; newly: COVID-19), the Surgeon General is not to be taken seriously.

[mcguire]

As I've not been commuting for a couple of years, I am way behind in my podcasts. Just this weekend, I listened to the March 10, 2020 episode of "Naked Scientists" (https://www.thenakedscientists.com/), a British radio science show from Cambridge. Chris Smith, a virologist, (https://www.thenakedscientists.com/users/chris-smith), at that time, said to buy beer rather than masks; you'll enjoy the beer and it'll protect you as well as a mask.

His concerns were that (1) cloth masks wouldn't help, and (2) that wearing masks incorrectly wouldn't help either. He was wrong about (1), but (2) is still a problem.

I'm sure I'll have opportunity to provide updates as I get further along. :-)

The Nature podcast didn't get on the mask bandwagon until early June, when they had an interview on the effectiveness of masks in this specific case.

No one I've seen has said that medical masks don't work.

[blub]

Maybe the population wouldn't have to reserve N95 masks for medical personnel if:

* the production hadn't been outsourced to China which then decided to ban exports while also accepting the PPE donations of other countries

* the government would have noticed that there's a pandemic brewing, and instead of saying "nothing to see here" would have ramped up PPE production or at least procured PPE from the market.

* failing all of the above, at least instituted an export stop so that the remaining PPE wouldn't have been bought from under their noses.

But yes, when one fails so utterly, one has to end up begging the people to work against their own interests with predictable results.

And yes, Fauci and the surgeon general lied. Nothing ambiguous about it, even if they were trying to save PPE for medical personnel.

[DanBC]

Can you show me the peer reviewed studies that you think Fauci etc showed have used to recommend mask wearing in the general population?

We had lots of studies around mask wearing, and most of them really struggled to show any kind of benefit.

[blub]

Whether they work for the general population is maybe a concern for Fauci, the government and the odd HN commenter. The message was that they don't work to protect individuals from the virus, hence they should not be bought by normal people.

That's obviously false. And an individual will be first and foremost concerned about their own safety, not if they can single-handedly stop the pandemic.

[DanBC]

> That's obviously false.

It's not obviously false, because there were studies available at the time that showed masks did not work to protect individuals, especially members of the public.

But, again, I'd be interested to read any studies you have that were 1) available at the time and 2) showed benefit of wearing masks.

[blub]

I've linked this somewhere else: https://news.ycombinator.com/item?id=25479729. This references studies from the SARS times and for flu. N95/FFP2 masks are pretty well established, they were used by front line workers in all the pandemics in the last decades.

That's why most Western countries were stockpiling them - as protection in case of a flu pandemic.

[fitzie]

saying that masks work, is a tad simplistic. there are many types of masks, and while they have their benefits there is plenty of evidence that mask wearing has not inhibited the virus from spreading in the population. there is little evidence that the casual masks that are being worn have significantly reduce the risk of exposure.

fauci was well justified when he said before that mask wearing isn't the solution to this pandemic, but now any nuanced discussion is not tolerated, which, perhaps, is the reason people aren't trusting the science. another reason is that politicians are making arbitrary decisions claiming it is what science (facts and data) told them to do.

[redisman]

Science is always wrong to begin with and it gets close to a correct answer with iteration. It’s actually not at all a solved problem how to communicate “science” to the public. Your comment is a perfect example of one of these annoying fallacies I see around covid messaging. Don’t you think they “changed their tune” because they got better data that showed that masks are helpful? You seem mad that they couldn’t conjure clinical data in early 2020 that showed that masks cut the transmission by X%

[ahepp]

To go one level deeper, I feel your comment exhibits a fallacy as well.

Sure, science progresses over time. It's fallacious to say that science is wrong because we used to think the sun revolved around the earth. Evidence evolved, ideas changed.

But dismissing all instances of scientists changing their mind, when they really just lied, as "oh, evidence evolved" is the kind of thing that (I feel) erodes trust in science.

I think the evidence is strong that advice against masks was a lie meant to prevent panic, not honestly communicated "best we could do at the time" science. A lie with good intent for overall public health, but dishonest nonetheless.

[redisman]

It did seem like there was a initial misinformation panic statement to try to save ppe for medical staff

[wl]

Evidence is nice, but sometimes it makes sense to reason from known principles. SARS-CoV-2 was known to spread through respiratory droplets almost from the beginning. Particulate respirators are known to protect people against respiratory droplets. Surgical masks are routinely used for source control of respiratory droplets in surgical settings. A mask recommendation made a lot of sense, even before there was data suggesting they were specifically helpful against SARS-CoV-2.

[mcguire]

Respiratory droplets do not travel very far.

"For respiratory exhalation flows, the critical size of large droplets was also between 60 and 100 μm, depending on the exhalation air velocity and relative humidity of the ambient air. Expelled large droplets were carried ... less than 1 m away at a velocity of 1 m/s (breathing)." -- https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0668...

Hence the idea of social distancing (for airborne droplets) and frequent hand washing (for surface contamination). (And, of course, staying home if you have symptoms like coughing or sneezing.) Convincing people to use masks consistently and correctly has previously been shown (and remains!) to be an uphill fight.

(I note that there was a meeting of epidemiologists in March, 2020, where famously, no one wore masks. How far are you willing to to go to lie?)

Later, it was found that viruses could be carried by much smaller particles, much farther.

"Our laser light scattering method not only provides real-time visual evidence for speech droplet emission, but also assesses their airborne lifetime. This direct visualization demonstrates how normal speech generates airborne droplets that can remain suspended for tens of minutes or longer and are eminently capable of transmitting disease in confined spaces." -- https://www.pnas.org/content/117/22/11875

[OrangeMonkey]

In general, I think you are right. In this case, the person involved admitted in an interview with "The Street" 6/12/2020 that it was to keep the supply for healthcare workers.

> "Well, the reason for that is that we were concerned the public health community, and many people were saying this, were concerned that it was at a time when personal protective equipment, including the N95 masks and the surgical masks, were in very short supply. And we wanted to make sure that the people namely, the health care workers, who were brave enough to put themselves in a harm way, to take care of people who you know were infected with the coronavirus and the danger of them getting infected."

[choward]

> it was to keep the supply for healthcare workers

I've heard this argument several times. I don't buy it at all. They could have instructed people to make their own masks especially since everyone was stuck at home. There is no shortage of fabric that I'm aware of. It also would have given manufacturers more time to produce masks.

Also, it's not okay to lie to the public, especially if you're supposed to be non-political. They deliberately lied and didn't apologize. There's no way I can trust someone who does that. That's not how my brain works.

[YZF]

I think it's a little more complicated/nuanced than that.

It's clear that some medical professionals felt the science wasn't there, and ofcourse it wasn't. The science takes a long time. i.e. there was no science that showed that for Covid19 the use of masks would make a difference. Sure, it's common sense, but medical professionals don't use common sense. There might have been some papers about the Flu (with mixed results) and there were some other random papers, but there was no clear evidence either way. If touching the virus and then touching your face is the primary vector then it is possible that masks make things worse. Again, to me it was always common sense you should wear a mask (and not touch it and not touch your face) but even here on HN people were arguing both ways given the existing papers/publications.

Then there's the nature of public health, where your messaging isn't necessarily about what's the right choice for an individual, but rather what's the right choice for the public as a whole.

I don't think the public would understand the nuance of make a mask vs. buy a mask, ofcourse there'd be a run on PPE. Even with the message there was a run on PPE. Good luck trying to find an N95 mask in Home Depot last year in the first few months of the pandemic.

I'm not sure what's the takeaway here, public health officials, and medical professionals are not really scientists, they don't communicate science, they have their own objectives. Generally their objectives should be aligned with our objectives as a public but they may not be aligned with our objectives as individuals within that public.

The bigger issue to me is how slow the response has been across the board in most places, because all those bureaucracies move at the pace of a snail, pretty much every country on this planet botched the initial handling of this (of special note is China ofcourse) and blew away our chance of containing this early on. By the time we were on the mask vs. no mask debate the die was already cast (and a lot of people wore masks anyways and a lot of those who didn't wouldn't wear one anyways).

[Aunche]

> Most recently, when the government, most especially the Surgeon General and even Fauci, told people that masks don't work.

They said that mask don't work in preventing you from contracting covid. This holds up to this day. As early as February, Fauci was saying that he was discouraging masks because he wanted make sure there were enough for healthcare workers and sick people, but people are acting like it was a secret agenda. I think that people are deliberately misinterpreting Fauci's words, so that they can blame someone besides themselves or their own social circle for the pandemic. People completely ignored stay at home orders and social distancing. Masks are only meant as a last resort if you have no other choice.

[blub]

Having closely followed the mask discussion, they lied, plain and simple. Maybe they didn't specifically use a certain wording, but the aim was clear - discourage people from wearing any masks.

And N95+/FFP2+ masks work at protecting one from the virus, why else would medical personnel wear them? They work even when not worn perfectly.

Of course many are being purposefully obtuse and call those "respirators" in order to muddy the waters and don't even consider them to be masks, even if one wears them on their face and breathes through them. Those so-called respirators are high-quality masks, that's all there is to it.

[cle]

> So read the science. Listen to the science. But read up further, and make educated decisions. Don't just listen to "experts" blindly.

This is not feasible advice. I can't read studies and correctly interpret and summarize them in every area of science which could affect my day-to-day decisions. That's insane.

We need to work on improving the trust of our scientific institutions, so that we can continue living our lives and focusing our efforts on our specializations. This may involve changing the institutions themselves to fix legitimate issues (like the funding fiasco), addressing misunderstandings by the public that also contribute to mistrust, etc.

There's no reason to throw the baby out with the bathwater. As with many issues of our day, the challenge will be in disciplined focus on the issues themselves and what changes we should make to address them, instead of surrendering to tribal bickering.

[tjr]

This is not feasible advice. I can't read studies and correctly interpret and summarize them in every area of science which could affect my day-to-day decisions. That's insane.

But if you wanted to study something out and make your own decision, you should be free to do so.

I think nutrition is a great example. Despite decades of research, there appears to be no one single answer as to what constitutes a healthy diet, or what the most important aspects of a healthy diet are.

Low-calorie? Low-carb? Dairy-free? Meat-free? Low-sodium? Low-fat? High-fat?

As an individual, you have lots of choices, including eating whatever you want with no particular dietary plan at all. But if you want to read a book or read research papers and change your diet, you can.

[cle]

Sure you can, go for it. But I doubt that many people have the time nor the skills required to actually come to some justified conclusion. The scary part is that many of them think they do. Often the very ones who tell you "read the science" or "just go read some papers" are the ones who dramatically underestimate the amount of effort and nuance it takes to synthesize the results of numerous researchers into a coherent meta-analysis. You can try, sure, and personally I enjoy it, but unless you're already an expert researcher in the field, you should be very skeptical that any conclusions you make are actually valid.

It takes an enormous amount of domain knowledge to reasonably interpret the statistics of experiments, epidemiological studies, etc. We may think we can read them and come to our own conclusions, but I think it's usually our hubris that leads us to believe that those conclusions are justified and not just rolls of the dice.

[lmm]

> We need to work on improving the trust of our scientific institutions, so that we can continue living our lives and focusing our efforts on our specializations.

Putting it that way is putting the cart before the horse. Our institutions need to become more trustworthy, then we'll be able to trust them more. Even then, I suspect a certain level of scepticism is needed to keep them honest.

[cle]

That is a great way to improve trust. There are other ways as well, and we should work on them all.

[lmm]

Not necessarily. If our scientific institutions are actually untrustworthy, then the public is correct to mistrust them, and acting to artificially increase public trust in them would be counterproductive.

[cle]

There are a lot of people out there with unfounded mistrust. Some of it is justified, some of it is not. These things are not mutually exclusive.

[UncleMeat]

> So read the science. Listen to the science. But read up further, and make educated decisions. Don't just listen to "experts" blindly.

For most people, even educated people, they are more likely to hold correct beliefs by listening to experts blindly than investigating papers themselves. Sometimes experts are wrong. But experts are wrong way less often than laypeople. A culture of a bunch of inexpert youtubers reading papers and convincing people of medical advice is perilous.

[xenophonf]

Scientific knowledge is _always_ wrong in a strict sense. Every law, every theory has a confidence interval attached. Every measurement, an error bar. Sometimes that confidence interval is really, really big, like our model of how gravity works when things aren't too big or moving too fast. Sometimes those error bars are really, really big, like how we though non-HEPA masks wouldn't really help prevent the spread of a novel airborne virus, so more conservative pandemic mitigations were necessary to prevent unnecessary deaths. The good news is that the scientific process emphasizes and incentivizes increasing those confidence intervals and reducing errors (but never eliminating them—that's impossible). We know a lot more now than we did this time last year. It's why we have not just one but several safe and effective vaccines, for example.

[passivate]

> It's why we have not just one but several safe and effective vaccines, for example.

Well, if I were to follow your skeptical line of thinking, I'd say that vaccines are never safe/effective, they simply have a confidence interval attached to them. Furthermore, vaccines made using novel processes have no long term data. Its never this simple :)

You see, we can't really apply such logic to every day decisions. The 'error bar' you referred to is of little benefit here, and also subject to the same skepticism. Its useful when you know a high percentage of the the variables, and all the mechanisms where data can be wrong/insufficient, etc. But you can't know that when you know so little of the pathogen. Its turtles all the way down :)

Also, HEPA masks cannot filter out COVID-19 (~ 100nm). HEPA filters, or sterile filters in general are roughly around 0.2um (200nm).

(source: works in biotech on vaccines)

[drdeca]

“Safe” and “known to be safe” aren’t the same thing.

Something can both not cause problems, but also be such that one cannot yet rule out with high confidence that it might.

[passivate]

Agreed. I'm for healthy skepticism, not paranoia. But like everyone else I do have my preferences and biases. Given a choice, I'd much rather take a vaccine based on established 'boring' tech.

[drdeca]

Oh, yes, I agree that for two different vaccines for the same illness, one of which was developed using novel methods / is of a novel style, and where the two different vaccines have individually been tested the same amount with equivalent results regarding safety and effectiveness, it usually makes sense to prefer the one which is of a style which has been tested more thoroughly.

Like, it probably makes sense to trust glass or ceramic glasses somewhat more than plastic or metal glasses, just by how long the technologies have been around?

I think I hadn't read all of your previous comment, and was largely responding to just the first part. Whoops?

[xenophonf]

You absolutely can apply that kind of logic to everyday decisions. It's called risk-benefit analysis.

[passivate]

I explained why you can't - Because you don't know what you don't know. An error margin or error rate or error probability or whatever error measure you choose to use, relies on your knowledge of the problem set. This is already known to most researchers. Establishing probabilities such as "life on planet X" or "existence of aliens" etc are problematic for the same reasons. Certainly these are not every-day decisions, but merely to illustrate the point. I suspect we might agree somewhere in the middle - maybe our disagreement is on what constitutes every day decisions?

[jussij]

The stupidity of the mask debate is breath taking and the general public needs to take some of the responsibility.

There is a reason surgeons wear masks in operating theaters.

[exporectomy]

I think it only really became a debate once a popular idea spread around saying that wearing a mask is to protect others from yourself. Before that, mask wearing seemed a little bit selfish or paranoid, but that idea turned it into a moral action. And morals give people a feeling of rightousness in judging others and fighting against them. Then when people start fighting, others find themselves in the position of enemy so they fight back out of indignation.

[RavlaAlvar]

What’s the problem with low fat diet?

[fsflover]

https://news.ycombinator.com/item?id=26126183

[sanp]

Well, this is how you get anti-vaxxers as well...don't listen to the experts blindly and do your own "research". Most of the population lacks the skills (as evidenced by general math scores) to make even a partially informed judgment if they were to do their own "research"...